The value of hyperbilirubinaemia in the diagnosis of acute appendicitis.

2.50
Hdl Handle:
http://hdl.handle.net/10147/141057
Title:
The value of hyperbilirubinaemia in the diagnosis of acute appendicitis.
Authors:
Emmanuel, Andrew; Murchan, Peter; Wilson, Ian; Balfe, Paul
Affiliation:
Department of Surgery, St. Luke's Hospital, Kilkenny, Ireland. arhemmanuel@gmail.com
Citation:
The value of hyperbilirubinaemia in the diagnosis of acute appendicitis. 2011, 93 (3):213-7 Ann R Coll Surg Engl
Journal:
Annals of the Royal College of Surgeons of England
Issue Date:
Apr-2011
URI:
http://hdl.handle.net/10147/141057
DOI:
10.1308/147870811X566402
PubMed ID:
21477433
Abstract:
No reliably specific marker for acute appendicitis has been identified. Although recent studies have shown hyperbilirubinaemia to be a useful predictor of appendiceal perforation, they did not focus on the value of bilirubin as a marker for acute appendicitis. The aim of this study was to determine the value of hyperbilirubinaemia as a marker for acute appendicitis.; A retrospective analysis of appendicectomies performed in two hospitals (n=472). Data collected included laboratory and histological results. Patients were grouped according to histology findings and comparisons were made between the groups.; The mean bilirubin levels were higher for patients with simple appendicitis compared to those with a non-inflamed appendix (p<0.001). More patients with simple appendicitis had hyperbilirubinaemia on admission (30% vs 12%) and the odds of these patients having appendicitis were over three times higher (odds ratio: 3.25, p<0.001). Hyperbilirubinaemia had a specificity of 88% and a positive predictive value of 91% for acute appendicitis. Patients with appendicitis who had a perforated or gangrenous appendix had higher mean bilirubin levels (p=0.01) and were more likely to have hyperbilirubinaemia (p<0.001). The specificity of hyperbilirubinaemia for perforation or gangrene was 70%. The specificities of white cell count and C-reactive protein were less than hyperbilirubinaemia for simple appendicitis (60% and 72%) and perforated or gangrenous appendicitis (19% and 36%).; Hyperbilirubinaemia is a valuable marker for acute appendicitis. Patients with hyperbilirubinaemia are also more likely to have appendiceal perforation or gangrene. Bilirubin should be included in the assessment of patients with suspected appendicitis.
Item Type:
Article
Language:
en
MeSH:
Adolescent; Adult; Aged; Aged, 80 and over; Appendectomy; Appendicitis; Bilirubin; Biological Markers; C-Reactive Protein; Child; Child, Preschool; Female; Humans; Hyperbilirubinemia; Leukocytes; Male; Middle Aged; Retrospective Studies; Sensitivity and Specificity; Young Adult
ISSN:
1478-7083

Full metadata record

DC FieldValue Language
dc.contributor.authorEmmanuel, Andrewen
dc.contributor.authorMurchan, Peteren
dc.contributor.authorWilson, Ianen
dc.contributor.authorBalfe, Paulen
dc.date.accessioned2011-08-29T10:08:11Z-
dc.date.available2011-08-29T10:08:11Z-
dc.date.issued2011-04-
dc.identifier.citationThe value of hyperbilirubinaemia in the diagnosis of acute appendicitis. 2011, 93 (3):213-7 Ann R Coll Surg Englen
dc.identifier.issn1478-7083-
dc.identifier.pmid21477433-
dc.identifier.doi10.1308/147870811X566402-
dc.identifier.urihttp://hdl.handle.net/10147/141057-
dc.description.abstractNo reliably specific marker for acute appendicitis has been identified. Although recent studies have shown hyperbilirubinaemia to be a useful predictor of appendiceal perforation, they did not focus on the value of bilirubin as a marker for acute appendicitis. The aim of this study was to determine the value of hyperbilirubinaemia as a marker for acute appendicitis.-
dc.description.abstractA retrospective analysis of appendicectomies performed in two hospitals (n=472). Data collected included laboratory and histological results. Patients were grouped according to histology findings and comparisons were made between the groups.-
dc.description.abstractThe mean bilirubin levels were higher for patients with simple appendicitis compared to those with a non-inflamed appendix (p<0.001). More patients with simple appendicitis had hyperbilirubinaemia on admission (30% vs 12%) and the odds of these patients having appendicitis were over three times higher (odds ratio: 3.25, p<0.001). Hyperbilirubinaemia had a specificity of 88% and a positive predictive value of 91% for acute appendicitis. Patients with appendicitis who had a perforated or gangrenous appendix had higher mean bilirubin levels (p=0.01) and were more likely to have hyperbilirubinaemia (p<0.001). The specificity of hyperbilirubinaemia for perforation or gangrene was 70%. The specificities of white cell count and C-reactive protein were less than hyperbilirubinaemia for simple appendicitis (60% and 72%) and perforated or gangrenous appendicitis (19% and 36%).-
dc.description.abstractHyperbilirubinaemia is a valuable marker for acute appendicitis. Patients with hyperbilirubinaemia are also more likely to have appendiceal perforation or gangrene. Bilirubin should be included in the assessment of patients with suspected appendicitis.-
dc.language.isoenen
dc.subject.meshAdolescent-
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshAged, 80 and over-
dc.subject.meshAppendectomy-
dc.subject.meshAppendicitis-
dc.subject.meshBilirubin-
dc.subject.meshBiological Markers-
dc.subject.meshC-Reactive Protein-
dc.subject.meshChild-
dc.subject.meshChild, Preschool-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshHyperbilirubinemia-
dc.subject.meshLeukocytes-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshRetrospective Studies-
dc.subject.meshSensitivity and Specificity-
dc.subject.meshYoung Adult-
dc.titleThe value of hyperbilirubinaemia in the diagnosis of acute appendicitis.en
dc.typeArticleen
dc.contributor.departmentDepartment of Surgery, St. Luke's Hospital, Kilkenny, Ireland. arhemmanuel@gmail.comen
dc.identifier.journalAnnals of the Royal College of Surgeons of Englanden
dc.description.provinceLeinster-

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